Papilledema

Papilledema refers to the swelling of the optic discs caused by increased intracranial pressure. It typically occurs in both eyes.

The optic disc, also known as the nerve head, is the area where the optic nerve enters the back of the eye. The optic nerve serves as the pathway connecting the eye to the brain.

Several factors can lead to increased intracranial pressure, including:

• Malignant hypertension
• Tumors
• Head injuries
• Infections, bleeding, or inflammation in the brain or meninges (the protective tissues surrounding the brain and spinal cord)
• Tinnitus (ringing or noise in the ears)
• Encephalitis (inflammation of the brain. It can be caused by viral or bacterial infections, or by immune cells mistakenly attacking the brain).
• Meningitis
• Blood clots in the brain
• Iron deficiency anemia
• Certain medications
• Idiopathic intracranial hypertension, where no identifiable cause is found.

It is crucial to seek medical attention if you experience any vision changes, especially if accompanied by headaches, nausea, or vomiting, as the causes of papilledema can be serious.

When a patient presents with a headache, unexplained nausea, and vomiting, a doctor will examine their eyes using an ophthalmoscope. This device shines a bright light into your eyes, allowing the doctor to observe changes in the appearance of the optic nerve and the blood vessels that pass through it.

Papilledema may be discovered while your healthcare provider evaluates the patient for other conditions associated with headaches, nausea, and vomiting. Papilledema should be monitored closely. It can develop over hours or weeks.

Initially, the concern is less about vision loss. Papilledema resulting from increased intracranial pressure typically does not damage the optic nerve unless the pressure remains high for an extended period. The primary concern is the potential for brain damage, which can be life-threatening. Urgent brain imaging, such as computerized tomography (CT scan), Magnetic resonance imaging (MRI), or Optical Coherence Tomography (OCT), is necessary. If the pressure is not reduced, papilledema can ultimately lead to permanent damage to the optic nerve and eventual blindness. 

Sources:

www.clevelandclinic.org

www.barrowneuro.org

www.merckmanuals.com

Photo sources:

www.radiopaedia.org

www.ophthalmologyadvisor.com

www.eyerounds.org

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